Retinopathy of Prematurity

What are the signs and symptoms of retinopathy of prematurity?

Early ROP doesn’t show any apparent signs or symptoms. This is why it’s important for babies to get eye exams to monitor for ROP, especially those born prematurely. Getting these eye exams with the special tools used by pediatric eye specialists is the only way to detect ROP.

How do we diagnose retinopathy of prematurity? 

If your baby is born prematurely, it’s important to have them examined for ROP. Premature babies should have a dilated eye exam a month or two after birth depending on how prematurely they were born. During this procedure, an ophthalmologist (eye specialist) uses eye drops to widen your baby’s pupils. Then, the doctor uses a light and magnifying tool to look inside your baby’s eyes.

Your baby may need multiple eye exams throughout their stay in the NICU and after discharge from the hospital. Depending on the results, your doctor may recommend urgent treatment or follow-up appointments to monitor the growth of the blood vessels inside the retinas. These follow-up appointments are essential to detect any issues and start treatment to preserve your child’s vision.

Retinopathy of prematurity stages of severity

ROP is described in zones and stages. Zones refer to how far blood vessels have grown in your baby’s eye. Stages describe how abnormal the blood vessels are. Your ophthalmologist will let you know your baby’s zone and stage.

Retinopathy of prematurity stages can change quickly or gradually over time. If your baby is diagnosed with ROP, your doctor may tell you the stage of the disease:

• Stage 0 or 1: These stages indicate a mild condition that usually gets better without treatment. Your doctor will monitor your child’s condition over time.
• Stage 2 or 3: These are moderate stages of ROP. Some babies get better with no treatment. But others need treatment to prevent retinal detachment, an eye problem that can cause vision loss.
• Stage 4: This stage indicates a partially detached retina and requires treatment.
• Stage 5: This is the most severe form of ROP, and the retina is completely detached. Babies with stage 5 ROP may have visual impairment or blindness, even with treatment.

How do we treat retinopathy of prematurity?

Most babies with ROP don’t need treatment, but it’s very important to keep follow-up appointments since ROP can worsen rapidly. Premature babies remain at high risk until the ophthalmologist tells you that the blood vessels are fully grown.

Some babies may require urgent ROP treatment to prevent vision loss. Retinopathy of prematurity treatment may include:

• Injections:Our experts inject medication into the eye to reduce abnormal blood vessel growth.
• Lasers:Lasers directed at the sides of the retina create scar tissue like a fence to prevent the retina from detaching.
• Surgery: If your baby has a partially or completely detached retina, your doctor may recommend one of two surgeries.
  • Scleral buckle surgery: An ophthalmologist places a flexible band around the sclera (the white part of the eye). The band remains around the eye and pushes the sclera toward the eye wall to help keep the retina in place until your child’s eye grows normally.
  • Vitrectomy: An eye doctor removes vitreous (a gel-like fluid that fills the eye) and scar tissue formed by ROP to position the retina correctly. The doctor may also use lasers to seal the retina in position.

Even with treatment, babies with ROP may still have vision loss or blindness. Compared to babies born full term, all premature babies, including those who had ROP, are at higher risk for having eye problems. They may need glasses or patching. They may develop strabismus, where eyes aren’t straight. For these reasons, premature babies need eye exams with ophthalmologists throughout their lives, especially if they had ROP.

Why choose us for ROP treatment? 

Our pediatric ophthalmologists are experts in their field and have many years of experience diagnosing, monitoring and treating retinopathy of prematurity in infants. This care tailored to babies is especially important in getting an accurate diagnosis and the best treatment.

Our pediatric eye specialists work closely with experts throughout the hospital to ensure that premature babies receive comprehensive care. The ophthalmology team collaborates with our Neonatal Intensive Care Units (NICU), which are among the best in the nation.

We also work with the Department of Ophthalmology at the University of Colorado School of Medicine, which helps ensure that we are at the forefront of education and research in pediatric eye conditions. Through our collaborations, leading research and innovative early detection systems, we are providing the best care in pediatric ophthalmology.

Helpful resources

March of Dimes supports research, leads programs and provides education and advocacy so that every family can have the best possible start.

Prevent Blindness has the simple mission of preventing blindness and preserving sight, with a focus on medical conditions such as ROP, where blindness is very preventable.